依普利酮获批的适应症有什么？

Binds to mineralocorticoid receptors, thereby blocking the binding of aldosterone, a component of the renin-angiotensin-aldosterone system (RAAS). Aldosterone synthesis occurs primarily in the adrenal gland and is regulated by multiple factors, including angiotensin II and non-RAAS mediators such as adrenocorticotropic hormone (ACTH) and potassium. Aldosterone binds to mineralocorticoid receptors in epithelial tissues (such as the kidneys) and non-epithelial tissues (such as the heart, blood vessels, and brain) and increases blood pressure by inducing sodium reabsorption and possibly other mechanisms.

What are the approved indications for eplerenone? 

1. Congestive heart failure after acute myocardial infarction: Eplerenone can improve the quality of life of patients with left ventricular dysfunction (ejection fraction ≤ 40%). Clinical trials have proven that eplerenone can also be used for congestive heart failure after acute myocardial infarction.

2. Anti-hypertensive: Eplerenone can be used alone or in combination with other anti-hypertensive drugs for the treatment of hypertension. 

The recommended dose of eplerenone for adults is an initial dose of 50 mg orally once daily. Maintenance dose: 50 mg orally, 1-2 times daily. Maximum dose: 100 mg/day. Obvious antihypertensive effects appear within four weeks of taking the drug. Patients whose blood pressure responds inadequately to the initial dose may be increased to 50 mg twice daily. Initial adult dose for the treatment of congestive heart failure: 25 mg orally once daily; gradually increase to target dose over 4 weeks as tolerated by the patient. Target dose: 50 mg orally once daily.

Side effects 1%-10% Central nervous system: dizziness, fatigue; endocrinology and metabolism: hyponatremia (dose-related), proteinuria, gynecomastia, hypercholesterolemia; gastrointestinal tract: diarrhea, abdominal pain; genitourinary system: abnormal vaginal bleeding, breast pain (males: ≤1%), kidney: elevated serum creatinine (heart failure, post-myocardial infarction: 6%); respiratory system: cough, flu-like symptoms.